Individual provider Active NPI

Kim Nhat Thi Nguyen

  • Professional Counselor
  • Hayward, CA
National Provider Identifier
1831582881
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9943 Issued in CA
Practice address
21455 Birch St Ste 201
Hayward, CA 94541-2165
Phone
(510) 844-6745
NPI assigned
Mar 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 9943 CA Primary

Addresses

Primary practice location

21455 Birch St Ste 201
Hayward, CA 94541-2165

Mailing address

21455 Birch St Ste 201
Hayward, CA 94541-2165
Phone (510) 844-6745

Other practice location 1

5348 University Ave
Suite 101
San Diego, CA 92105-8025
Phone (619) 229-2999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260403000126 CA Practitioner - Mental Health Counselor 0941785349 Practice locations: Hayward, CA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22248 Main St
Hayward, CA 94541-4005
Phone (510) 255-5654

22248 Main St
Hayward, CA 94541-4099

28434 Rochelle Ave
Hayward, CA 94544-5452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9943CAMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1831582881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21455 BIRCH ST STE 201",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945412165",
            "telephone_number": "510-844-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21455 BIRCH ST STE 201",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945412165",
            "telephone_number": "510-844-6745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5348 University Ave",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921058025",
            "country_code": "US",
            "telephone_number": "619-229-2999",
            "fax_number": "619-229-2998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KIM NHAT",
        "middle_name": "THI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "9943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.